What are the adverse effects in the long-term application of low-dose methotrexate? Is amino glucose so magical?

This is the third issue of information for you! Glucosamine treatment of osteoarthritis, to guard against drug allergy! Patients with osteoarthritis should not be given glucosamine for treatment because of side effects such as allergies, the Australian rheumatology Society said on February 13.glucosamine (also known as glucosamine, glucosamine or glucosamine) is a kind of glucosamine in human body, which mainly exists in joint lubricant and cartilage. However, with the growth of age, the ability of human body to synthesize glucosamine will gradually deteriorate.glucosamine supplement on the market is a chitin extracted from shrimp and crab shells, and then hydrolyzed by acid. It is commonly used in clinic to improve the condition of patients with osteoarthritis and cartilage protection.at present, glucosamine is a drug approved by European and Chinese drug regulatory authorities for the treatment of osteoarthritis. Glucosamine is recommended for the treatment of osteoarthritis as a cartilage protector in the guidelines for the diagnosis and treatment of osteoarthritis (2010) of the rheumatology branch of the Chinese Medical Association.while in the United States, food additives are commonly used, and ordinary people can buy them freely in supermarkets.the Australian Society of Rheumatology issued the warning because the Australian drug regulatory agency (TGA) has reported hundreds of allergic reactions to glucosamine.in the past decade, TGA has reported 336 cases of side effects of glucosamine (and chondroitin, another supplement for osteoarthritis).among them, 263 cases were allergic, ranging from mild to severe.the reason may be that glucosamine is the extract of aquatic products, so people who are allergic to seafood should be cautious when taking it.in addition, other allergic causes have not been known, but there are three types of people to pay special attention to: people taking anticoagulant drug "warfarin", people with diabetes, people with kidney problems "Lancet": in the coming decades, osteoporotic fractures will rise sharply! The number of osteoporotic related fractures is expected to increase dramatically in the next few decades due to the increasing risk of falls and fractures in elderly patients, the lancet rheumatology recently published.osteoporosis is a disease with a large number of patients, which can be divided into two categories: primary and secondary.primary osteoporosis generally occurs in postmenopausal women, with a high incidence within 5-10 years.idiopathic osteoporosis mainly occurs in adolescents, which is relatively rare.secondary osteoporosis can be caused by any disease or drug that affects bone metabolism, or can be caused by a definite cause such as fracture.rheumatoid arthritis is a disease that can lead to osteoporosis.osteoporosis is characterized by low bone mass, destruction of bone microstructure, increased bone fragility and easy fracture.in 2013, the International Osteoporosis Foundation reported that there is one case of osteoporotic fracture in the world every three minutes. About 50% of women and 20% of men will encounter the first osteoporotic fracture after the age of 50, and 50% of the patients with the first osteoporotic fracture may have another osteoporotic fracture. osteoporotic fracture is one of the main causes of disability and death in the elderly. as osteoporosis is not fully diagnosed and treated, it is expected that the number of high-risk elderly patients with falls and fractures will increase dramatically in the coming decades, and the prescription of anti osteoporosis drugs is decreasing in most countries. the reasons for inadequate treatment of osteoporosis include: medical staff's lack of understanding of osteoporosis, while patients think it is inevitable aging; patients stop taking drugs because of worrying about the side effects of some anti osteoporosis therapies; non drug therapy is not paid attention to, such as vitamin D and calcium supplement, increasing exercise capacity, etc.; the curative effect of existing drugs is still good, but it still needs to be improved To develop and evaluate novel treatments for the prevention and treatment of osteoporosis. but at present, we should strengthen the screening of high-risk patients with osteoporotic fracture through the nursing system, or improve the current treatment strategy, so as to continuously reduce the risk of osteoporotic fracture. What are the adverse reactions of low-dose methotrexate for 23 months? Low dose methotrexate (ld-mtx) is the most commonly used drug for systemic rheumatism and the first-line drug for rheumatoid arthritis. although methotrexate has been widely used in clinical practice for more than 30 years, there is little data on the incidence of adverse events (AE) from randomized, placebo-controlled trials. a randomized controlled trial in North America recruited 6158 patients with a median follow-up of 23 months and a median dose of 15 mg / wk. among the randomly assigned participants, 81.2% were males, with a median age of 65.7 years and a median body mass index of 31.5 kg / m2. of the 2391 participants assigned to ld-mtx, 2080 (87.0%) had significant AE, with an increased risk of gastrointestinal reactions (HR, 1.91 [CI, 1.75-2.10]), pulmonary diseases (HR, 1.52 [CI, 1.16-1.98]), infectious diseases (HR = 1.15 [CI, 1.01-1.30]) and blood related diseases (HR, 1.15 [CI, 1.07-1.23]). studies have shown that compared with placebo, ld-mtx use is associated with increased (small to moderate) risk of skin cancer, gastrointestinal reactions, infectious diseases, lung diseases and blood related diseases, while kidney related AE is reduced. References: 1// annals.org /aim /article-abstract /2761423 /adverse -effects -low -dose -methotrexate -randomized -trial